Priya Raman
Sr. Claims Analyst · Selective
PR
Claim
CLM-2026-48221
Claimant
Marcus Chen Contradictions
Loss · LOB
Workers' Comp · Shoulder soft-tissue · 03/18/26
Reserve
$47,500
OIA Score
87/100
Run Carpe Intel
Summary Intelligence Documents Payments Notes Timeline
Claims Reasoning Engine · Case synthesis

Mr. Chen reports a disabling right-shoulder rotator cuff strain sustained on the warehouse floor 03/18, with a 10-lb lifting restriction and an August RTW target. Across 35 days the continuum has returned 9 contradiction signals spanning Instagram (jet-ski posts 03/28, beach-trip lifting imagery 04/05), a GoFundMe opened 04/02 framing recovery as "back better than ever," and a Carpe Intel image-forensics sweep that confirmed 3 manipulation-free posts showing unrestricted overhead motion. Pro+ IR delivered courtroom-ready evidence chain today. Recommend reserve repositioning and scheduled IME within 10 days before representation attaches.

Generated 04/22 14:12 PDT · 6 continuum sources · analyst M.K. · evidence chain preserved

OIA Score breakdown Score 87/100 · factor weighting explained

87/100
High-severity · Physical Activity + Travel reason codes
Percentile: top 4% of 52,940 active claims under monitoring.
Contradiction strength
Very High
Recency
< 24 hours
Source diversity
4 platforms
Identity confidence
94%

Investigation trail

Step 1
Auto Score
58 → re-scored 87 after signals
Step 2
OIA
6 signals · Physical Activity + Travel
Step 3
IR · Pro+
Delivered 04/22 · 14-pg package
Step 4
Carpe Intel
9 contradictions · 94% confidence

Signal stack Evidence captured across the continuum · newest first

Instagram · Jet-ski outing, Clearwater Beach
OIA · Physical Activity
Instagram
Reel · "blessed weekend 🌊" · 0:23
03/28 · 10 days post-FNOL · unrestricted rt. arm extension · face match 98%
View evidence →
Instagram
Story · beach volleyball, Siesta Key
04/05 · overhead serve visible · captured before 24-hr expiry
View evidence →
GoFundMe · "Help Marcus recover stronger"
OIA · Financial
GoFundMe
Fundraiser · $4,200 raised of $10,000 goal
Opened 04/02 · narrative: "back better than ever" · contradicts stated 8-mo RTW
View evidence →
Facebook · Tampa Bay Jet Ski Club check-in
OIA · Travel + Physical
Facebook
Check-in · Clearwater Jet Ski Rentals · group photo
03/28 · 6 co-participants · location-verified via EXIF
View evidence →
Local news · Blackhill Logistics annual charity run
OIA · Lifestyle
Public
Tampa Bay Times · community photo roundup
04/11 · subject tagged in 5K run finisher photo · running form intact
View evidence →
Court
Hillsborough County · no litigation filed
Clear as of 04/22 · representation letter not on file
View evidence →
Order deeper IR Escalate to SIU Re-run Carpe Intel Export evidence PDF
Evidence chain preserved · courtroom-ready